Background: Oral cancer accounts for more than 90% of all cancers and are among the ten most frequent human malignancies. Majority of the oral cancers arises from longstanding premalignant lesions. Usage of tobacco products and areca nut are considered as the greatest risk factors of oral cancer. Despite some progress in diagnostics and therapeutic options, the 5-years overall survival rate stagnates up to only 40–50 % over a 40-years period. Despite of the easy access of oral cavity for clinical examination, OSCC is usually diagnosed in advanced stages. Lack of awareness about the effects of risk factors and presentation of oral cancer is the main reason for oral cancer not being identified in the early stage.

Objectives: 1. To evaluate the awareness and knowledge of habit related oral changes among tobacco and areca nut users.

 2.To identify the awareness level and make necessary modifications in the existing health education programmes and thereby making more people aware about the oral cancer, its complications and the role of habits in its development. 

Methods: A survey based questionnaire is being conducted among the new out patients with these habits coming to the Community Department of PMS College of Dental Science and Research, Vattappara, Trivandrum.

Results: 50 patients participated in this pilot study. Among these patients, majority of them fell in to the education level of basic literacy.  58% of patients thinks that oral cancer is a disease of old age. 94% patients with habits know that these can lead to oral cancer. About 54% people are unaware about the precancerous oral mucosal changes. Only18% patients were found to be ignorant about the importance of early detection of precancerous lesions.

Conclusion: From a mere culture, tobacco and arecanut has now become a routine habit of many people. Even though most of the people know about oral cancer, majority are unaware about the precancerous conditions. Patients should be made aware that oral cancer can be prevented if detected at its earliest manifestations. Unfortunately, most educational programmes focus on tobacco and areca nut usage and their relation to oral cancer .So, the awareness programmes on oral cancer should emphasis on the premalignant conditions also.